Sarrafzadeh A S, Kiening K L, Bardt T F, Schneider G H, Unterberg A W, Lanksch W R
Department of Neurosurgery, Virchow Medical Center, Humboldt-University, Berlin, Federal Republic of Germany.
Acta Neurochir Suppl. 1998;71:186-9. doi: 10.1007/978-3-7091-6475-4_54.
Brain tissue PO2 in severely head injured patients was monitored in parallel with two different PO2-microsensors (Licox and Paratrend). Three different locations of sensor placement were chosen: (1) both catheters into non lesioned tissue (n = 3), (2) both catheters into contusioned tissue (n = 2), and (3) one catheter (Licox) into pericontusional versus one catheter (Paratrend) into non lesioned brain tissue (n = 2). Mean duration of PtiO2-monitoring with both microsensors in parallel was 68.1 hours. Brain tissue PO2 varied when measured in lesioned and nonlesioned tissue. In non lesioned tissue both catheters closely correlated (delta Licox/Paratrend: mean PtiO2 < 5 mm Hg) after 20 hours post insertion. In pericontusional tissue PtiO2 was reduced relative to non lesioned tissue (delta lesioned/non lesioned: mean PtiO2: 10.3 mm Hg). In contusioned brain tissue PtiO2 was always below the "hypoxic threshold" of 10 mm Hg, independent of the type of microsensor used. During a critical reduction in cerebral perfusion pressure (< 60 mm Hg), PtiO2 decreased measured with both microsensors. Elevation of inspired oxygen fraction, normally followed by a rapid increase in tissue PO2, only increased PtiO2 when measured in pericontusional and nonlesioned brain. To recognize critical episodes of hypoxia or ischemia, PtiO2-monitoring of cerebral oxygenation is recommended in nonlesioned brain tissue.
使用两种不同的PO2微传感器（Licox和Paratrend）对重度颅脑损伤患者的脑组织PO2进行了同步监测。选择了三个不同的传感器放置位置：（1）两根导管均置于未受损组织中（n = 3），（2）两根导管均置于挫伤组织中（n = 2），以及（3）一根导管（Licox）置于挫伤周围组织，另一根导管（Paratrend）置于未受损脑组织中（n = 2）。两种微传感器同步进行PtiO2监测的平均持续时间为68.1小时。在受损和未受损组织中测量时，脑组织PO2有所不同。在未受损组织中，插入后20小时，两根导管的测量结果密切相关（Licox/Paratrend差值：平均PtiO2 < 5 mmHg）。在挫伤周围组织中，PtiO2相对于未受损组织降低（受损/未受损差值：平均PtiO2：10.3 mmHg）。在挫伤脑组织中，PtiO2始终低于10 mmHg的“缺氧阈值”，与所使用的微传感器类型无关。在脑灌注压严重降低（< 60 mmHg）期间，两种微传感器测量的PtiO2均下降。吸入氧分数升高通常会导致组织PO2迅速升高，但仅在挫伤周围和未受损脑组织中测量时PtiO2才会升高。为了识别缺氧或缺血的关键发作，建议在未受损脑组织中进行PtiO2监测以评估脑氧合情况。
